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Who's Afraid of the Big Bad C-Section?

by Stefanie Wilder-Taylor

My sister-in-law just had a baby and she had four hours of labor, pushed for one hour (with seven minutes between contractions so she could rest) while talking to her doctor and holding her husband’s hand, and her beautiful baby boy slid out like a tiny miracle.

Everything was perfect.

I’ve had two c-sections.

Until the other day, I didn’t think I was missing out on anything. But to hear her talk about what an amazing experience it was left me wondering if I’d gotten the short end of the child birth stick.

“It was the most natural experience of my entire life,” my sister-in-law gushed when I entered her hospital room. She was flying high, by the way, and her mood wasn’t due to morphine like mine was when I was wheeled out of recovery trailing my catheter tubes behind me.

“It’s like, now I understand what our bodies are made for. It all makes perfect sense,” she said tearing up at the realization.

It’s not like I don’t know what our bodies are meant for. Because I do. I know what a vagina is for. I just didn’t use mine for that. And it’s not that I never wanted to. I didn’t request a c-section because I was planning a fabulous vacation and needed to know my schedule. Although if you read the news these days they’d have you believe that despite the risks involved in major surgery, women are lining up around the block for their C’s, poo poo’ing vaginal deliveries like they’re last season’s hemline.

According to MSNBC, the US’s C-section rates are among the highest in the world and only increasing. A lot of these C-sections are repeat C’s which according to the author of this article are highly unnecessary. The problem apparently is that these darn doctors are saying once a C always a C when women should at least try to attempt a VBAC (vaginal birth after C-section). I guess being one of those women this article is referring to: a repeat C offender, I feel at once ripped off and defensive.

When I got knocked up with my first baby, I already knew I’d be having a C-sec. I’d been treated for a large uterine fibroid multiple times and my top notch female surgeon told me –no vaginal birth. “Are you certain?” I’d asked, not because I was so upset at the thought just because I figured I should know the reasons. “I shouldn’t even try?”

“No. You have scars on your uterus and if you went into hard labor, your uterus could rupture. Even though there’s only a small chance of that happening, if it happened you could lose the baby and you could also die. You don’t want to take that risk.

“So you’re saying I should definitely give it a try then. Ha ha.” Obviously I didn’t want to take that risk so I put it out of my mind, never second guessing it until I was pregnant with my first child and other women asked me about my birth plan.

thank you for this article - i had twins as well, and had a horrible labor, delivery and recovery....i was in labor for 36 hours, my epidural wore off after my pushing my daughter for 3 hours and then she ultimately was vacuumed out, with an episiotomy as well. then i still had to deliver my son...he came 2 hours later...after trying to push him out, it was determined that he was tangled in the cord, and voila - i then had a c-section! i was probably the most miserable mother on the floor in days after...glaring jealously at all of the other mothers enjoying their babies while i could barely walk the halls and one of mine was in the NICU and the other in the well-baby nursery because i was too much of a mess to take care of her. i have to say that that experience really scared me off of having any more children for good.

Lizzney09.08.10

THANK YOU!! As a repeat offender myself, I will verify that yes women really do say that to you. Complications from a first delivery led to a C, which is leading to C2, and I've had at least 4-5 women say, "of course you can still try for a VBAC" I guess my birthing goals are different. My birth plan includes being alive with my baby at the end :)

Hello Stefanie: I've been thinking a lot about women's birth experiences & I commend all women no matter how their baby/ies were delivered for walking that walk of fire. As you point out, m y concern is that there are more uncessary C-sections now and that proactive support of uncomplicated labor isn't the standard...I don't think that most OBs learn about how to provide labor support..the emphasis seems to be dealing with complications and protecting against litigation. I've been reading the book "Proactive Support of Labor: The challenge of normal childbirth" by Paul Reuwer and it's heartbreaking that much of the evidence cited is not adhered to by OBs. Evidence shows that continuous labor support by a nurse or midwife or OB leads to lower C-sections. He points out that the C-section pandemic (between 20-30% in western countries and climbing p. 9) is not result of indications such as breech, multiple pregnancies, severely compromised pregnancies, or emergencies..."the alarming observation is that the vast number are the easy exit strategy for first-stage labor disorders in healthy women w/ singleton term fetus in cephalic presenation...the populations presumed to be low risk." pg 9-10
Most women are low risk and should be able to have vaginal births...it's a matter now, I think, for women to demand supported labor and respect for their birth plans & candid discussion about all options. There is also literature that acknowledges that women should fare better after vaginal birth esp when it comes to their pelvic floors..it's a matter of better education and again "support" of the woman during labor. I am hopeful, with advocacy, that there will be a more balanced approach which offers continuous labor support with technical interventions "if necessary." Fortunately, at age 40 I was able to have a
"natural" vaginal birth (the not so natural but perhaps "necessary" part: pictocin to augment when I "stalled" at 6 inches, I had insulin drip and fluid drip, and aniomtomy to replenish lost animiotic fluid)...I labored sitting up for about 8 hours and pushed w/ a squat bar for 45 minutes...I believe with all my heart that I was able to do it because of continuous support from a friend who served as my doula and is also a trained labor & delivery nurse & my husband's encouragement...I think without my doula I would not have fared so well, as I was "at risk," and my husband, bless his heart, would not have known the "system". Perhaps one solution is to advocate for safe and satisfying birth experiences not either/or.

Michi09.08.10

Birth may be natural but it is also something that women have been dying from for centuries. I had a vaginal birth, but because the child would not come I had to be induced: child is a week late and induced and I STILL had 12 hours of hard labor (36 altoghether), got to tell you, not eager to re-experience that.
A good friend, all ready for a nice, natural, pain-med free birth when her water breaks, it is green and she finds herself having a C-section, not ifs ands or buts about it. She's a little gun shy about a VBAC, don't really blame her.
I get that a C-section is major surgery but giving birth is not a foolproof thing. If you want to try a VBAC, and no one says there's a good reason not to, go for it. But I also see where scheduling a C-section may be the best way to go.

verybecca09.08.10

I had a horrible c-section after planning for a natural birth, hypnobirthing classes, etc. I'm extremely jealous of friends who tell me about their births, even the "epic" ones involving 7 straight hours of pushing. Homebirths kill me. I wish my body could do that. Maybe it could have done it just fine. Maybe I didn't need the pitocin or the epidural or the shot of ketamine when my anesthesia didn't kick in while my OB was cutting into my abdomen. I'll never know.